My Lords, I believe it falls to me to be a back-marker. I can be brief, not least because I agreed with much of what my noble friend Lord O’Shaughnessy had to say. However, it might be helpful if I were to explain, purely from my own point of view, why some of the criticisms levelled at the Bill are excessive. First, the structure of the legislation—which provides a power to make payments that are then subject to a number of specific constraints and criteria—is not unusual. One sees this in a lot of legislation. Treating Clause 1 in isolation is therefore a mistake; it must always be treated in the context of the Bill as a whole.
Secondly, on the scope of the Bill, it would have been perfectly possible—I presume; I was not party to the discussion—for Ministers to bring forward legislation with a purpose simply to seek to replicate the existing EU reciprocal healthcare agreements. However, the nature of the agreements we will enter into with our partners across Europe are as yet undetermined. This is not about the transition period. This is effectively about the political declaration and what the future relationship looks like. As my noble friend said—and no doubt the Minister can add more specifics if necessary—the regulations that have been laid separately are intended to deal with the immediate consequences if we leave without any deal and without bilateral agreements with other countries across Europe in place.
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What are we trying to do here? I hope noble Lords will collectively agree that the Bill should pass because, as my noble friend Lord Cormack said, if we do not have it we will not be able to agree to maintain reciprocal healthcare arrangements across Europe. It is in our interests and it is devoutly to be wished for by the public. When we discuss those bilateral agreements, however, we may not be able to do so with every country. We may have to discuss them in the specific context of the arrangements for mobility across Europe, because the reciprocal healthcare agreements are presently structured in relation to freedom of movement across Europe, and freedom of movement may vary in future. Other countries may look at agreements with the United Kingdom at the same time and ask, perfectly reasonably, on what basis the United Kingdom is proposing to have a certain healthcare agreement with Spain, Italy or Cyprus, but not proposing to have something similar with them, if it promotes freedom of movement, mobility and the development of global Britain, for example.
That is what we are looking for. If we construct what we are doing as simply reproducing the present EU-UK relationship, we might as well not leave. As it
happens, I am a remainer. I might well take that view, and deeply resent the fact that we are devoting an enormous amount of time, energy and money to seeking to reproduce the existing relationship with the European Union. However, if we leave, I would far rather that we did so on the basis that we were able to take aspects of our relationship with the European Union which are generally regarded as positive and apply them more widely. It does not seem an extravagant notion on the part of Ministers that the Bill should be brought forward on that basis. Parliament may say that we are giving the Secretary of State the power to spend money on hip replacements in Arizona, but we are not. We are giving the Secretary of State, under regulations which we agreed to, the power to pay for healthcare outside the United Kingdom where that is subject to an international healthcare agreement, but not otherwise.
There is a benefit to participating in the debates on the Trade Bill at the same time. We will have to think in a broader context about whether the Constitutional Reform and Governance Act 2010 provides sufficient basis for the scrutiny and ratification of treaties. We will inevitably agree some form of ratification process for such international agreements in future, and they will apply to any international healthcare agreements as well. To that extent, we should rest on that. The regulations that flow from it will be implementing legislation in relation to those agreements which, strictly speaking, under CRaG, the House of Commons can choose not to ratify—we cannot, but it can.